慢性肾脏病非透析患者血清高敏心肌肌钙蛋白T的影响因素分析  

Influence factors of serum high-sensitivity cardiac troponin T among chronic kidney disease patients

作　　者：孙黎[1,2] 於佳炜[1] 项方方[1] 曹学森[1] 聂宇昕 余金波[1] 滕杰[1] 方艺[1] 丁小强[1] 成云[1] 邹建洲[1] 

机构地区：[1]复旦大学附属中山医院肾内科,上海200032 [2]南京医科大学第一附属医院肾内科

出　　处：《中华肾脏病杂志》2015年第12期887-892,共6页Chinese Journal of Nephrology

基　　金：科技部重大新药创制项目（2012zx09303007）

摘　　要：目的 探讨慢性肾脏病（CKD）非透析患者血清高敏心肌肌钙蛋白T（hs-cTnT）水平的影响因素,分析肾源性及心源性因素在其中的作用.方法 采用横断面研究的方法,收集577例CKD非透析住院患者的临床资料,使用组间比较、单因素或多因素线性回归分析探讨血清hs-cTnT的影响因素.结果 577例CKD非透析患者hs-cTnT中位数为0.013（0.007,0.029）μg/L,＜0.003 μg/L（检测下限）者10例（1.7％）,＞0.014μg/L（健康人群第99百分位值）者268例（46.4％）.单因素分析结果提示,年龄、男性、高血压、糖尿病、收缩压、舒张压、血磷、血甲状旁腺素、血超敏C反应蛋白（hsCRP）、血β2微球蛋白、同型半胱氨酸、血胱抑素C、尿微量白蛋白与尿肌酐比值（UACR）和左室质量指数（LVMI）与hs-cTnT自然对数值（Ln hs-cTnT）呈正相关;高密度脂蛋白、血红蛋白、血浆白蛋白、血钙、MDRD公式估算的肾小球滤过率（eGFR）、左室射血分数（LVEF）与Ln hs-cTnT呈负相关.多因素分析结果提示,高龄、男性、合并糖尿病、高血胱抑素C、高UACR、低eGFR、高LVMI与血清hs-cTnT水平升高相关（P＜0.05）.结论 血清hs-cTnT水平与慢性肾脏病相关心血管疾病（CKD-CVD）的传统及非传统危险因素相关,肾损伤及心脏损伤与CKD非透析患者血清hs-cTnT升高相关.Objective To analyze the influence factors of serum high-sensitivity cardiac troponin T （hs-cTnT） for non-dialysis chronic kidney disease （CKD） patients, and to further investigate cardiac and renal effects on hs-cTnT.Methods Cross-sectional study was applied.Clinical data of 577 non-dialysis CKD patients were collected.Comparison between groups and lineal regression analysis were utilized to investigate the influence factors of hs-cTnT.Results Median level of hs-cTnT was 0.013 （0.007-0.029） μg/L, with 1.7% undetectable （hs-cTnT 〈 0.003 μg/L）, and 46.4% greater than 99th percentile （hs-cTnT 〉 0.014 μg/L） of the general population.Multivariate linear analysis displayed that higher Ln hs-cTnT was significantly associated with older age, male, diabetes,higher Cys C, higher urine albumin-to-creatinine ratio （UACR）, lower estimated glomerular filtration rate （eGFR） and higher LVM[（P 〈 0.05）.Conclusions Traditional and non-traditional risk factors of CKD-cardiovascular disease are shown to be associated with serum hs-cTnT level.Cardiac and renal injury may be associated with elevated hs-cTnT among non-dialysis CKD patients.

关 键 词：肾功能衰竭 慢性 心血管疾病 危险因素 

分 类 号：R692[医药卫生—泌尿科学]